SOCIALIST REPUBLIC OF VIET NAMIndependence - Freedom – Happiness No: 160 Book No: 01/2011 BIRTH CERTIFICATE Original Full name: LE PHAN HOANG KY Sex: Male Date, month, year of birth: Ma
Trang 1SOCIALIST REPUBLIC OF VIET NAM
Independence - Freedom – Happiness
No: 160 Book No: 01/2011
BIRTH CERTIFICATE
(Original)
Full name: LE PHAN HOANG KY Sex: Male
Date, month, year of birth: May 20, 2011 In words: The twenty of May, two thousand and eleven
Place of birth: Tu Du hopital, Ho Chi Minh city
Ethnic group: Kinh Nationality: Vietnam
Full name of father: LE HOANG QUY
Ethnic group: Kinh Nationality: Vietnam Year of birth: 1984
Permanent/temporary residence: Loc Thanh hamlet, Loc Hung village, Trang Bang district, Tay Ninh province
Full name of mother: PHAN THI TUYET LAN
Ethnic group: Kinh Nationality: Vietnam Year of birth: 1990
Permanent/temporary residence: Loc Thanh hamlet, Loc Hung village, Trang Bang district, Tay Ninh province
Place of registration: PEOPLE’S COMMITTEE Loc Hung village, Trang Bang district, Tay Ninh province
Date of registration: June 8, 2011
Remarks:
Full name of the birth declarant: LE HOANG QUY
Relationship with the birth-declared person: father
Executer THE SIGNER OF THE BIRTH CERTIFICATE SIGN FOR THE CHAIRMAN
Vice-Chairman
(signed) (signed and stamped)
Tran Van Buot Nguyen Van Phuc